How much rates vary
Facilitymedian $2,399 · 10th to 90th $95 to $4,898Professionalmedian $81 · 10th to 90th $44 to $166
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $51.29 Median $1,230.27 Typical High $7,762.47 | Facility | None | $51.29 | $1,230.27 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $91.20 Typical High $144.54 | Professional | None | $43.65 | $91.20 | $144.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $4,897.79 | Facility | None | $933.25 | $3,162.28 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $154.88 | Professional | None | $72.44 | $85.11 | $154.88 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $107.15 Median $125.89 Typical High $229.09 | Professional | 50 · Both sides | $107.15 | $125.89 | $229.09 |
CDPHP Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $114.82 | Professional | None | $66.07 | $66.07 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $100.00 Typical High $1,096.48 | Facility | None | $74.13 | $100.00 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $66.07 Typical High $302.00 | Professional | None | $36.31 | $66.07 | $302.00 |
Emblem Health Setting Facility Modifier None Typical Low $34.67 Median $52.48 Typical High $162.18 | Facility | None | $34.67 | $52.48 | $162.18 |
Emblem Health Setting Professional Modifier None Typical Low $89.13 Median $102.33 Typical High $165.96 | Professional | None | $89.13 | $102.33 | $165.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $53.70 Median $79.43 Typical High $100.00 | Professional | None | $53.70 | $79.43 | $100.00 |
Highmark BCBS Setting Facility Modifier None Typical Low $562.34 Median $602.56 Typical High $812.83 | Facility | None | $562.34 | $602.56 | $812.83 |
Highmark BCBS Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
MVP Health Care Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
MVP Health Care Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $208.93 | Professional | None | $42.66 | $42.66 | $208.93 |
United Setting Facility Modifier None Typical Low $338.84 Median $1,148.15 Typical High $4,365.16 | Facility | None | $338.84 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $29.51 Median $66.07 Typical High $194.98 | Professional | None | $29.51 | $66.07 | $194.98 |
Univera Setting Facility Modifier None Typical Low $37.15 Median $74.13 Typical High $165.96 | Facility | None | $37.15 | $74.13 | $165.96 |
Univera Setting Professional Modifier None Typical Low $53.70 Median $79.43 Typical High $95.50 | Professional | None | $53.70 | $79.43 | $95.50 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $45.71 Typical High $47.86 | Professional | 52 · Reduced service | $21.88 | $45.71 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $18.20 Typical High $19.50 | Professional | 53 · Discontinued | $8.71 | $18.20 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $69.18 Typical High $72.44 | Professional | 54 · Surgery only | $32.36 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $13.80 Typical High $14.45 | Professional | 55 · Aftercare only | $6.46 | $13.80 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $9.12 Typical High $9.55 | Professional | 56 · Pre-op care only | $4.37 | $9.12 | $9.55 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $53.70 Typical High $85.11 | Professional | 53 · Discontinued | $40.74 | $53.70 | $85.11 |
Where New York sits
The same service costs 3.3 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New York· 36th of 51
$85.11
AK $214KY $64.57
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.